Individual
SUSAN ELLEN POE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
2221 W DETROIT ST, BROKEN ARROW, OK 74012
(918) 615-6492
Mailing address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
110980
TX
225X00000X
Occupational Therapist
Primary
1237
OK
225X00000X
Occupational Therapist
OTT.Z12117
LA
Other
Enumeration date
01/22/2009
Last updated
06/26/2018
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